Question of the Day

Have you been impacted by the government shutdown?

Special correspondent John Zarocostas also interviewed Dr. Howard Zucker, World Health Organization (WHO) assistant director general for Health, Technology and Pharmaceuticals in Geneva last week. Dr. Zucker, 46 , is a graduate of the George Washington University School of Medicine in Washington and has held senior academic posts at Yale, Columbia and Cornell medical schools.

Question: What’s the objective of the proposed task force the conference in Rome asked you to set up?

Answer: The objective is that the world of counterfeit medication is growing, and we believe at WHO that we should tackle this now, before the problem gets any larger, and to raise awareness of this problem but not create a situation where people are nervous about going to their pharmacist.

I think what we need to do right now is bring increased awareness to the problem across the globe and figure out how to utilize all the resources we have within the United Nations system, and also the stakeholders involved and then to identify where these sources of medications are being manufactured and to eliminate them.

Q: How big is the problem?

A: It’s hard to estimate how big it is. Numbers vary, but I can tell you that in the developing world, it is a significant problem, and in the developed world it is growing — particularly with the technology that we have, such as the Internet — and there’s concern it’s going to get larger.

Q: Given that the Internet is borderless and under no international regulatory regime, how do you plan to enhance cooperation to limit bogus Internet pharmacies selling counterfeit products?

A: I think the issue here is we have to address all the stakeholders involved.

Anyone who is selling illegal products — we need to identify them, authorize the international police forces that exist to find them and to stop them, and appropriately prosecute individuals who have participated in this kind of trade.

This is different from the counterfeiting of other products because it really does impact on people’s lives. People can die as a result of it.

Q: What have been some of the most documented cases of counterfeit medicines that have led to deaths and serious illness?

A: It depends on the countries and regions. In the developing world, obviously, the use of medications such as pain medications, and medications given straightforward for colds, and then in addition to that, anti-malarial, and anti-retroviral medications for HIV/AIDS are a concern.

There are also documented cases of putting antifreeze into medications that children are taking, and causing deaths in developing countries as well. In the developed world, these [counterfeit] medications are going to be on the Internet — sometimes steroids supplements, lifestyle medications, medications that people are not as quick to go to their doctor and ask for — whether it’s from embarrassment or just the fact that they can get it over the Internet.

Q: What was the message that you got at the Rome conference from enforcement agencies like Interpol?

A: Interpol recognizes this is a concern, and I look forward to sitting down with them in the coming weeks and months to actually address this further. But they have the knowledge, and the expertise in certain areas, of addressing issues of narcotics and trafficking and other areas where they have the skills.

Q: Are the penalties too light for counterfeiters of medicines?

A: Obviously. What happens if penalties were harsher? Then, people would start to steer away from that, and those with impure motives would go into something else. So I think each country has to address this on their own.

We did bring this up regarding the legislative and enforcement issues, and how one modifies laws is really dependent on each member state WHO represents.

Q: When do you think the task force will get the OK to start work?

A: Well, the task force has been supported by all the parties involved, and now it is an issue of strategizing the issues involved.

Q: Could it be up and running by this summer?

A: I hope before that. …

The five key areas to be addressed are technology, legislative, enforcement, regulatory and mass communications. Those are the five that we think cover a lot of the issues involved. But there may be other subsets that it may be necessary to address.